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Related Experiment Videos

Decreasing post-succinylcholine myalgia in outpatients.

B Melnick, J Chalasani, N T Uy

    Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
    |May 1, 1987
    PubMed
    Summary

    Pretreatment with d-tubocurarine (dTc) and lidocaine effectively reduced muscle pain and fasciculations after succinylcholine administration in surgical patients. This combination therapy offers a promising strategy for managing postoperative myalgias.

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    Area of Science:

    • Anesthesiology
    • Pharmacology
    • Surgical Patient Care

    Background:

    • Succinylcholine is frequently used for rapid muscle relaxation during anesthesia.
    • Succinylcholine administration can lead to undesirable side effects, including myalgias (muscle pain) and fasciculations (muscle twitching).
    • Effective pretreatment strategies are needed to mitigate these adverse effects.

    Purpose of the Study:

    • To evaluate the efficacy of four different pretreatment regimens in reducing succinylcholine-induced myalgias.
    • To compare the incidence of fasciculations and muscle pain across various pretreatment protocols.

    Main Methods:

    • A randomized controlled trial involving 395 adult female outpatients undergoing ambulatory surgery.
    • Four pretreatment groups received: saline, d-tubocurarine (dTc) alone, lidocaine alone, or a combination of dTc and lidocaine prior to succinylcholine.

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  • Fasciculations were observed, and postoperative muscle pain was assessed via telephone interviews 40-48 hours postoperatively.

    • Main Results:

    • Groups pretreated with d-tubocurarine (dTc) showed reduced fasciculations compared to non-dTc groups.
    • The dTc-lidocaine combination group exhibited the lowest incidence of moderate to severe fasciculations.
    • Patients receiving dTc, lidocaine, or the dTc-lidocaine combination reported significantly less muscle pain, particularly moderate to severe pain, than the saline group.

    Conclusions:

    • Pretreatment with d-tubocurarine, alone or in combination with lidocaine, effectively reduces succinylcholine-induced fasciculations.
    • The combination of d-tubocurarine and lidocaine demonstrated the greatest efficacy in preventing both fasciculations and moderate to severe myalgias.
    • This study supports the use of dTc-lidocaine pretreatment to improve patient comfort after succinylcholine administration.